How lucky I am to be living here in
Wexford because I really believe if I was still in Dublin I would not be
getting as good help from local services as I am getting here. I am
not able to name the people who help so I will give them all pen-names, and
they will all know who they are should they be reading this.
I would have to start with “Laura” my wonderful physiotherapist who has been
with me since the beginning of all this - when we thought it was something that
could be fixed. It was me and Laura
meeting every week, doing our exercises, and it was her urging me to call and
get the doctors to see me sooner which led to my eventual diagnosis . What a huge help she has been, always full of
encouragement, and Laura helped me to stay walking much longer than the
hospital team wanted. She has also done
referrals to lots of other services.
So I had an Occupational Therapist (OT) before diagnosis who we will call “Marie”. Marie was a great help with practical things
around the house, and once I was told I had Motor Neuron Disease she passed me
over to the Palliative Care team (yes I hated the word “palliative” too when I
first heard it, but it’s about living the best way possible). My new OT from Palliative Care we will call “Beth”
- someone else with a very positive attitude right on my wavelength - and when
Beth calls to the house it’s not all business…we manage to have a great laugh
too! Marie used to call us “MacGyver” as we always
seemed to find ways to overcome the latest difficulty we had, and she always
said she was trying to keep up with us.
We have wonderful district nurses who we will call Victoria, Amy and Gina who
call in all the time. Especially Amy who
we see every week; again, it’s not all about MND - we chat about lots of
different things and laugh. I also have
a dedicated Palliative Care nurse. I
know, there’s that word again, but its about pain relief and management, and
believe me that is important. I am
allergic to morphine so will never enjoy the only legal high…had it once and
had to be resuscitated - the after-effects of which are not pleasant! As well as being in dire pain because they
give you Narcan to nullify the morphine; not a situation I ever want to be in
again.
You’ll already know from a previous blog about the progression from one boot to
a pair, then crutches, then finally the wheelchair. I now have my third wheelchair: this one is a
super-duper one tailored not just to fit me, but to fit around as best as
possible our house between the lounge and the bedroom. We will be breaking ground on our extension
very soon which is going to give us a new bedroom, a wet-room and a bigger
lounge. I will also have a new ramp for
access directly into the extension.
When this is built I will be able to have the new Hot Rod that is
waiting for me in a warehouse, but until the extension is finished there has
been no point in having it as there’s simply no room, no access and nowhere for
me to go on it. My Hot Rod will run on
batteries and Neil won’t need to push me around any more. And I will have to find someone to sign-write
it for me. Can anyone help me with this?
I’m really, really looking forward to the wet-room so I can at last have a
shower after 6 months of not being able to get in our existing shower. Bye-bye bed-baths…soon!
I wanted to write all that just to recognise how right this country can do
things on a local and personal level.
Unlike my experience of the government and the head office of the health
service who don’t seem to understand a simple question.
With the help of my friends lobbying politicians, a local TD (MP) raised my
issues in parliament, for which I thank him.
However the reply he got from the Junior Minister for Health was not an
answer to my question whatsoever, but a lot of spin! He didn’t tell me anything I didn’t already know;
in fact it was a condescending and patronising answer mostly not relevant to my
question. And I quote him:
“Motor Neuron Disease is a complex and challenging condition. The diagnosis,
treatment and care of individuals with motor neurone disease requires input
from a wide variety of services, ranging from GP and community services through
to acute hospital and specialist disability services.
“I understand that the individual at the centre of this case has complex needs.
The HSE has advised that numerous multidisciplinary meetings have taken place
to try to ensure appropriate care for her. She is currently receiving Continuous
Positive Airway Pressure Therapy at night time provided by HSE community
services.
“The HSE is continuing to explore all options for this patient’s future care.
The HSE remain available at all times to discuss these issues directly with the
individual and her family.
“The HSE advises that the question of whether a patient can access home
ventilation therapy, whether invasive or non-invasive, is not purely a
financial issue but must be considered across a number of dimensions,
including:
�
A proper discharge care plan, which is discussed
between the hospital consultant team and the appropriate primary or community
care team, needs to be agreed and activated to ensure the appropriate setup is
in place and can be sustained to meet the care needs of the patient over time.
�
Home ventilation needs appropriate equipment,
trained staff and both patient and family education as well as arrangement for
upkeep and maintenance of such ventilation equipment.
�
Nurses supervising such patients at home need to be
appropriately qualified and competent to supervise the patient clinically; and
�
A commitment to provide the necessary financial
resources to support the care arrangement into the future.
“As I mentioned earlier, this patient is currently using non-invasive
ventilation therapy in the home and I understand that there is currently no
clinical indication for full mechanical ventilation in this case.
“However, the HSE has advised that this case will be kept under review and
should a requirement for invasive home ventilation therapy be identified for
this patient in the future this matter will be considered by the relevant hospital
and community services.”
NOWHERE has my question been answered regarding Invasive Ventilation at
home. Who IS/ARE this HSE? WHO is making the decision? WHO is available to talk to me? HOW do I contact someone of influence? The idea of leaving the decision about
Invasive Ventilation until it “is indicated” – or in other words I need it – is
a ridiculous notion. They won’t be sat
around a table having tea and a discussion when I am gasping for my last
breath! Is it just me, or does it seem
ridiculous to you too?
I have now been forced to write another letter which my friend Elaine has
elaborated on, on my behalf, and she has sent it to all the relevant
politicians once again in the hope that we get a PROPER answer…
It looks like this:
CONCERNING: EIMEAR LYNCH-ROWE
Dear Minister Reilly
Firstly, I would like to thank you for
your attention to my initial contact regarding Eimear Lynch-Rowe and her
situation due to Motor Neuron Disease and in particular to the detailed
response which you sent to me last week. I would like to advise you that Eimear
and her husband Neil have requested that I act on their behalf regarding correspondence
with TDs and the Dail.
Since my initial email at the beginning
of April where I approached all TDs and Ministers advising about Eimear’s
condition and situation approximately forty members of the Dail have raised
questions directed at you, Minister White and the HSE. It is clear from the
responses received to date that Eimear’s case is receiving attention. However,
the question which Eimear needs an answer to has not actually been addressed.
Writing on behalf of Eimear and her
husband Neil, I can advise you that they are increasingly frustrated to see
that they are not the only ones ‘fobbed off’ with what are essentially mere
platitudes and stock responses. Consistently they have received stock replies
regarding the issue of home ventilation – that whether it is invasive or
non-invasive it cannot be considered in isolation and whether the patient has
access to such treatment is not purely financial.
Eimear and Neil are, naturally enough,
very aware of the need for a proper care plan to be in place, the need for
equipment, the need for staff training and family education as well as the
necessary qualification of supervisory nurses. It is rather patronising to
think that the individual who is actually living in these circumstances, living
with such an aggressive and rapid form of Motor Neuron Disease, would not be
aware of her needs. To receive this stock response from yourself, Minister
White and the HSE in these desperate and tragic circumstances is both
increasingly frustrating and unnecessarily upsetting.
What Eimear actually needs to know is
that the Government and the HSE will respect her wishes and her right to life
as and when her rapidly progressing MND reaches the point of making her lungs
no longer able to function – either independently or with non-invasive
ventilation.
Eimear is fully aware that she does not
need this treatment right now, she does not need it today. She is trying to
preserve and protect her future whilst she is still able to. She is attempting
to establish that she will be able to have her future, to have her right to
life, and she needs to do this now, before she will no longer be in a position
to fight for what she needs.
In direct communication with Eimear
yesterday I was asked to forward the following to each TD who has responded to
me:
“I
am amazed and upset that no-one I have contacted seems to have understood or
grasped the simple ambition of my first communication. So let me
simplify exactly and unequivocally precisely what it is that I want.
“When
I first raised the subject of Invasive Ventilation with my consultant Professor
Hardiman last December (2013), I expressed clearly my wish to stay alive via
this method as and when the time comes.
“She
told me no. Professor Hardiman said that the HSE would not sanction
this on cost grounds, and reiterated this position when I asked again in
February. On the latter occasion she gave a much clearer indication
that this decision was one of cost.
“Since
taking my very personal campaign and ambition into the public and national
domain, I have had many replies and statements using the arguments of ethics,
cost and quality of life. Each of these arguments can be dismissed
with one fact: that the HSE itself employs Dr. Tim O’Brien who also
has Motor Neuron Disease and has been living on Invasive Ventilation for at
least 14 years.
“At
this stage, having heard my situation raised in the Dail and had many replies
from various politicians and HSE employees, I am very tired of the pat reply
that “Invasive Ventilation is not indicated in (my) case at present.
“Of course it isn’t. But it WILL be, and given my most rapid and
aggressive progression of Motor Neuron Disease, it WILL be indicated very much
sooner, than later. And at that stage I will no longer be in this
now failing position to fight for what I want, and what is my right, when that
time comes.
“So
in very plain English, this is my question:
“When
the time comes, and when it is necessary, will Invasive Ventilation be
available to me, and if not, why not?
“And I need this
question answered URGENTLY.”
At this point in time, you have advised in
writing that the HSE is keeping Eimear’s case under review and that you have
undertaken to keep the chief whip appraised of any developments, requesting
that HSE officials meet Deputy Kehoe and Ms. Lynch-Rowe to discuss progress.
Whilst this is most definitely a step forward, in that Eimear’s case is
currently flagged, what she needs is not for her case to be kept under review
whilst she waits for the inevitable to happen.
What she needs is proactive recognition from the
HSE, her hospital consultation team and her primary/community care team. She
knows her illness means her lungs will fail. Her hospital team know her lungs
will fail. Her primary/community care team know her lungs will fail. She needs her support structure to plan for
this now, to know what her future shall be now. Not when her lungs fail.
I would like to thank you again for assisting
myself, Eimear and her family in this matter so far, and for continuing to support
and assist us in her fight. I would ask that you would ensure her question is
actually answered by the HSE on this occasion.
Yours sincerely,
Elaine Daly.
Someone should have
warned them that I will NOT stop shouting until someone hears my voice….even if
it’s a computer generated voice!
There’s more new (and old) pictures in my Facebook group – please join it.
More soon.
Ciao!
Eimear X